Mounjaro vs Semaglutide: Weight Loss, Side Effects, Price
Mounjaro (tirzepatide) and semaglutide are both GLP-1 medicines, weekly injection versus weekly injection or daily tablet. They were tested against each other in SURPASS-2. Semaglutide self-pay starts at $149 per month.
- Tested head to head
- SURPASS-2
At a glance: Mounjaro and Wegovy
Mounjaro and Semaglutide side by side
| Mounjaro | Semaglutide | |
|---|---|---|
| Medicine | Mounjaro | semaglutide |
| Active ingredient | tirzepatide | semaglutide |
| Manufacturer | Eli Lilly | Novo Nordisk |
| How it is taken | Weekly injection | Weekly injection or daily tablet |
| Approved for | Type 2 diabetes and heart risk | Type 2 diabetes, heart risk, and weight loss; also MASH liver disease, plus kidney disease in people who have type 2 diabetes |
| First FDA approval | 2022 | 2017 |
| Average weight loss in trials | Not listed | 14.9% (STEP 1, 68 weeks) |
| Most common side effect | Nausea 18% vs 4% on placebo | Nausea 20.3% vs 6.1% on placebo |
| List price | $1,112.16 per fill | $1,027.51 per pen |
| Self-pay from | Not listed | $149 per month |
| Medicare GLP-1 Bridge | Not listed | $50 per month, eligible Part D |
| FDA shortage | Resolved December 19, 2024 | Resolved February 21, 2025 |
Sources: FDA label, FDA label (DailyMed), pricinginfo.lilly.com, Novo Nordisk pricing.
Weight loss tested head to head
In SURPASS-2, Mounjaro went to one group and Semaglutide to the other, so the numbers compare directly.
| Trial | Who took part | Length | Group | A1C change |
|---|---|---|---|---|
| SURPASS-2 | Adults with type 2 diabetes on metformin | 40 weeks | Tirzepatide 5 mg weekly | -2.01 percentage points (mean HbA1c change) |
| SURPASS-2 | Adults with type 2 diabetes on metformin | 40 weeks | Tirzepatide 10 mg weekly | -2.24 percentage points (mean HbA1c change) |
| SURPASS-2 | Adults with type 2 diabetes on metformin | 40 weeks | Tirzepatide 15 mg weekly | -2.3 percentage points (mean HbA1c change) |
| SURPASS-2 | Adults with type 2 diabetes on metformin | 40 weeks | Semaglutide 1 mg weekly | -1.86 percentage points (mean HbA1c change) |
Trial sources: SURPASS-2 (PubMed).
Side effects compared
In each drug's label, participants were compared with a separate placebo group. First compare each drug with its own placebo.
| Side effect | Mounjaro | Placebo (Mounjaro trials) | Ozempic | Placebo (Ozempic trials) |
|---|---|---|---|---|
| Nausea | 18% | 4% | 20.3% | 6.1% |
| Diarrhea | 17% | 9% | 8.8% | 1.9% |
| Decreased Appetite | 11% | 1% | Not listed | Not listed |
| Vomiting | 9% | 2% | 9.2% | 2.3% |
| Dyspepsia | 8% | 3% | Not listed | Not listed |
| Constipation | 7% | 1% | 5% | 1.5% |
| Abdominal Pain | 6% | 4% | 7.3% | 4.6% |
Price and coverage compared
| Medicine | How you pay | Price |
|---|---|---|
| Mounjaro | List price before insurance | $1,112.16 per fill |
| Mounjaro | Mounjaro Savings Card (insured) | from $25 for up to a 3-month fill |
| Mounjaro | Commercial plan that does not cover it | $499 per month |
 Ozempic | List price before insurance | $1,027.51 per pen |
| Ozempic | Ozempic Savings Offer (insured) | from $25 monthly for up to 3 months |
| Ozempic | Self-pay: Ozempic pill (from 1.5 mg) | $149 per month |
 Wegovy | List price before insurance | $1,349.02 per month |
| Wegovy | Wegovy Savings Offer (insured) | from $25 per month |
| Wegovy | Self-pay: Wegovy pill 1.5 mg | $149 per month |
| Wegovy | Medicare GLP-1 Bridge (Wegovy, eligible Part D) | $50 per month |
 Rybelsus | List price before insurance | $1,027.51 per 30 tablets |
| Rybelsus | RYBELSUS Savings Offer (insured) | from $25 per fill covering 1, 2 or 3 months |
Prices checked November 2026 (9)
rybelsus.com, pricinginfo.lilly.com, mounjaro.lilly.com, Novo Nordisk pricing 1 2, NovoCare 1 2, TrumpRx, CMS.
Who should pick which?
- If you do not have diabetes, only Semaglutide is approved for weight loss.
- Semaglutide is approved for kidney disease when you have type 2 diabetes.
- Semaglutide is approved for MASH liver disease.
- Semaglutide appears on the Medicare GLP-1 Bridge list.
- If you pay cash, the published self-pay price for Semaglutide comes to $149 each month.
Your health history, other medicines, and coverage all factor into your prescriber's decision. Switching between them is up to them.